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      Increases in alcohol consumption in women and elderly groups: evidence from an epidemiological study

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          Abstract

          Background

          In most Western countries, alcohol consumption continues to increase, specifically among women and older adults. Insight into these trends may aid intervention strategies. Here we present data on alcohol consumption by age and sex as well as associations between alcohol use and demographic lifestyle/traits. The data are from a large (N>16,000) population-based Dutch sample, ascertained based on the presence of twins in the family.

          Methods

          A set of 16 indicators of normative and problematic alcohol use was assessed in participants of the Netherlands Twin Register between 2009–2012 (ages 18–97; 6,052 men; 10,535 women). Alcohol consumption and demographic/lifestyle traits, including educational attainment, work-related/financial stress, urbanization, religiousness, smoking/cannabis initiation, and BMI were described by age and sex. Associations were examined by regressing aspects of alcohol use on age, sex, their interaction, and demographic/lifestyle variables.

          Results

          Age, sex, and initiation of cigarette and cannabis use were the most important predictors of alcohol use. Frequency of alcohol use was lowest between 18–25 years, with 3.2% of men and .6% of women drinking 6–7 times/week, and highest above age 65 years, with 30.6-32.7% of men and 20.2-22.0% of women drinking 6–7 times/week. Women consumed the lowest quantities of alcohol between 25–45 years, with a 5.7-5.9% prevalence of excessive drinking (>14 glasses/week), and the largest quantities between 55–65 years (15.5% excessive drinkers). Age at alcohol initiation, onset of regular drinking, and first alcohol intoxication were lowest between ages 18–25 years and highest above age 65 years. Among older participants, men initiated alcohol use and regular drinking earlier, and had lower age at first intoxication than women, but among young adults, no sex differences were observed.

          Conclusions

          Alcohol consumption was high in the elderly Dutch population, especially among women. Alcohol initiation, onset of regular drinking, and first alcohol intoxication occur at increasingly younger ages, and the previous gap between men and women in age at alcohol initiation, onset of regular drinking, and first alcohol intoxication has closed almost entirely. Heavy alcohol use was most strongly predicted by older age, sex (male), and initiation of smoking and cannabis use.

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          Most cited references28

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          Genetic and environmental influences on alcohol, caffeine, cannabis, and nicotine use from early adolescence to middle adulthood.

          While both environmental and genetic factors are important in the etiology of psychoactive substance use (PSU), we know little of how these influences differ through development. To clarify the changing role of genes and environment in PSU from early adolescence through middle adulthood. Retrospective assessment by life history calendar, with univariate and bivariate structural modeling. General community. A total of 1796 members of male-male pairs from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Levels of use of alcohol, caffeine, cannabis, and nicotine recorded for every year of the respondent's life. For nicotine, alcohol, and cannabis, familial environmental factors were critical in influencing use in early adolescence and gradually declined in importance through young adulthood. Genetic factors, by contrast, had little or no influence on PSU in early adolescence and gradually increased in their effect with increasing age. The sources of individual differences in caffeine use changed much more modestly over time. Substantial correlations were seen among levels of cannabis, nicotine, and alcohol use and specifically between caffeine and nicotine. In adolescence, those correlations were strongly influenced by shared effects from the familial environment. However, as individuals aged, more and more of the correlation in PSU resulted from genetic factors that influenced use of both substances. These results support an etiologic model for individual differences in PSU in which initiation and early patterns of use are strongly influenced by social and familial environmental factors while later levels of use are strongly influenced by genetic factors. The substantial correlations seen in levels of PSU across substances are largely the result of social environmental factors in adolescence, with genetic factors becoming progressively more important through early and middle adulthood.
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            Behavioral and neural consequences of prenatal exposure to nicotine.

            To review evidence for the neurodevelopmental effects of in utero exposure to nicotine. Concerns about long-term cognitive and behavioral effects of prenatal exposure to nicotine arise from reports of increased rates of disruptive behavioral disorders in children whose mothers smoked during pregnancy. The relatively high rate of tobacco smoking among pregnant women (25% of all pregnancies in the U.S.) underlines the seriousness of these concerns. This review examines the largest and most recent epidemiological and clinical studies that investigated the association of prenatal nicotine exposure with health, behavioral, and cognitive problems. Because of the numerous potential confounding variables in human research, findings from animal studies, in which environmental factors are strictly controlled, are also discussed. Finally, neural and molecular mechanisms that are likely to underlie neurodevelopmental disruptions produced by prenatal nicotine exposure are outlined. A dose-response relationship between maternal smoking rates and low birth weight (potentially associated with lower cognitive ability) and spontaneous abortion is consistently found, whereas long-term developmental and behavioral effects in the offspring are still controversial, perhaps because of the difficulty of separating them from other genetic and environmental factors. Despite the wide variability of experimental paradigms used in animal studies, common physical and behavioral effects of prenatal exposure to nicotine have been observed, including low birth weight, enhanced locomotor activity, and cognitive impairment. Finally, disturbances in neuronal pathfinding, abnormalities in cell proliferation and differentiation, and disruptions in the development of the cholinergic and catecholaminergic systems all have been reported in molecular animal studies of in utero exposure to nicotine. Prenatal exposure to nicotine may lead to dysregulation in neurodevelopment and can indicate higher risk for psychiatric problems, including substance abuse. Knowledge of prenatal exposure to nicotine should prompt child psychiatrists to closely monitor at-risk patients.
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              A twin-pronged attack on complex traits.

              Before one starts the hunt for quantitative trait loci (QTLs) for a complex trait, it is necessary to show that the trait is genetically influenced. This evidence is most likely to come from the classical twin study--the demonstration that monozygotic twins are more similar for the trait than dizygotic twins. The strengths and weaknesses of twin studies are discussed, and it is suggested that, far from becoming irrelevant with advances in molecular biology, they can improve the efficiency of QTL detection and play an important role in unravelling developmental genetic mechanisms.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2013
                8 March 2013
                : 13
                : 207
                Affiliations
                [1 ]Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
                [2 ]Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
                [3 ]EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, Amsterdam, The Netherlands
                Article
                1471-2458-13-207
                10.1186/1471-2458-13-207
                3720280
                23497391
                ae5db34b-434c-490c-9084-2e31bfd88da5
                Copyright ©2013 Geels et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 July 2012
                : 24 February 2013
                Categories
                Research Article

                Public health
                alcohol consumption,demographic variables,epidemiology,lifestyle variables,older adults,women,young adults

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